Individual
JACK SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4901 DARTMOUTH COLLEGE HWY, WOODSVILLE, NH 03785-1412
(603) 747-3355
Mailing address
102 HIGHLAND AVE, SAINT JOHNSBURY, VT 05819-2577
(603) 723-3016
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PHCY-05103
NH
Other
Enumeration date
02/12/2025
Last updated
03/24/2025
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